4

Seeing If PrEP Works In Our Community

The million-dollar question is how will PrEP work in the real world? We know people behave differently in clinical trials than they do in their regular, daily lives. This PrEP demonstration project is being funded by the National Institutes of Health and will be locally implemented by San Francisco Department of Public Health at San Francisco City Clinic.

Share

What PrEP demonstration projects are happening?

Since we have the clinical evidence that proves that PrEP is safe and effective for HIV prevention, the million-dollar question is how will PrEP work in the real world? We know people behave differently in clinical trials than they do in their regular, daily lives. There are a number of PrEP demonstration projects happening in California, New York, Florida, and other states to help figure out whether people will be interested in taking PrEP and to evaluate the feasibility of offering PrEP at different community and/or clinical settings.

What questions will the PrEP demonstration project try to answer?

Will people want PrEP?

PrEP isn’t perfect for everyone. Specific demonstration projects will help figure out who is actually interested in using PrEP to maximize its potential as an HIV prevention tool.

How will people use PrEP?

There are lots of factors to consider, like pill-taking practices, activities of everyday life, condom use, how to best monitor and support people to take their pills correctly in the real world, etc.

How will sexual practices change for those taking PrEP?

While sexual risk-taking declined in clinical trials of PrEP when its protective benefit was unknown, it will be important to see what happens to sexual practices among people taking PrEP in more real-world settings. We’ll also learn more about how best to counsel and support people taking PrEP to best protect themselves from HIV.

Where should PrEP be delivered?

We need to figure out the best places and ways to offer PrEP to ensure people have access to it no matter how much money they have or whether or not they have health insurance.

Will PrEP be safe in the “real world”?

Safety is an important concern, and the demonstration projects and health care providers will monitor for safety and the potential for drug resistance as people use PrEP in a more real-world setting.

How can I help the PrEP demonstration project?

If you are interested in learning more about the PrEP demonstration project happening in San Francisco, we encourage you to visit the San Francisco City Clinic website. As of August 2013, the PrEP demonstration project in San Francisco is no longer enrolling.
Even if you don’t think PrEP is right for you, there’s something that everyone can do to help the PrEP demonstration project reach its full potential. It truly is a community effort. Be an informed advocate for the PrEP demonstration project, talk to your friends about it, and support participants you know.

What about other PrEP studies in the San Francisco Bay Area?

Bridge HIV at the San Francisco Department of Public Health is currently conducting NEXT PrEP, a new study evaluating the safety of different PrEP medication combinations (including maraviroc). They are also planning a study to test the safety of a PrEP gel that can be applied rectally. For more information, please visit www.joinprep.org.

What about PrEP studies outside the San Francisco Bay Area?

Check BETAfor the latest on PrEP research and AVAC for ongoing PrEP clinical trials and demonstration projects in other cities.

What do I need to know before joining a PrEP trial?

For folks considering joining a PrEP trial, please read this frank and honest articlewritten by columnist Matt Sharp in BETA(San Francisco AIDS Foundation’s bright and brainy resource in HIV prevention, treatment, and cure research).
The hope is when all the scientific evidence from these clinical trials and demonstration projects are put together, we will get a better picture of how well (or not well, depending on results) PrEP works across different settings and groups of people. PrEP is not a one-size-fits-all approach, and we need to figure out the nuances.
To stay on top of ongoing and upcoming PrEP research, please refer to the BETA for research updates and highlights.

"This project will help figure out who is actually interested in using PrEP to maximize its potential as an HIV prevention tool"

"There are lots of factors to consider, like pill-taking practices, activities of everyday life, condom use, how to best monitor and support people to take their pills correctly in the real world, etc"